Cornea - ARVO

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ARVO 2013 Annual Meeting Abstracts by Scientific Section/Group - CorneaCommercial Relationships: Adam J. Winkeler, None; Carolyn G.Begley, Santen, Inc. (C), ohnson & Johnson Vision Care, Inc. (C),ohnson & Johnson Vision Care, Inc. (F); Richard J. Braun, None;Robert Welch, NoneSupport: NIH Grant 1R01EY021794-01Program Number: 4356 Poster Board Number: C0094Presentation Time: 8:30 AM - 10:15 AMLongitudinal Mixed Effect OSDI Model in a Select Dry EyePatient Population after Acupuncture TreatmentVanessa Bowlin 1 , Sandeep S. Samudre 1 , Deepinder K. Dhaliwal 2 .1 Clinical Research, Eastern Virginia Eye Institute, Chesapeake, VA;2 School of Medicine, University of Pittsburgh, Pittsburgh, VA.Purpose: Keratoconjunctivitis sicca (KCS) is a commonmultifactorial disorder that negatively impacts a patient’s quality oflife, quality of vision, and ocular surface. Prior studies havedocumented beneficial effects of acupuncture for treatment of KCS.Modeling this behavior could facilitate better understanding ofacupuncture mechanism of action and KCS. This retrospective studyevaluates the ocular surface disease index (OSDI) in dry eye patientswho received acupuncture treatment.Methods: In this retrospective study, OSDI data from 49 dry eyepatients randomly assigned to either true or sham acupuncturetreatment group was re-evaluated. Participants had received twotreatments and were followed at regular intervals for period of 6months. Linear mixed effect model included: Treatment (tx), actualtime (atime), square of actual time (atime^2), centered age (agec),sex, and the following interaction terms: tx*atime, agec*atime,agec*atime^2, sex*atime, sex*atime^2. Potential confounders suchas age and sex were also included in the model.Results: After 6 months, OSDI was significantly reduced from abaseline of 34 ± 3 to 16 ± 4 (p= 0.01). The final linear mixed modelequation for OSDI = 29.39 - 7.39*tx + 0.530*agec + 35.50*sex + (-0.292 + 0.0858*tx + 0.133*sex + 0.00849*agec)*atime + (0.00103 -0.00118*sex - 0.00005*agec)*atime^2 + random slope of atime +random error. This equation also reported an immediate and rapidimprovement in OSDI scores in patients receiving true acupuncturetreatment. No significant differences in OSDI were observed aftersham acupuncture treatment (p=0.09). Also, there were no adverseeffects reported.Conclusions: The study demonstrated that acupuncture improvessymptoms in dry eye sufferers evaluated by OSDI. It is possible tomodel dry eye behavior using a linear mixed effect model. Modelingthis behavior facilitates understanding of KCS and acupuncture,which can be a useful complement to KCS treatment modalities.Commercial Relationships: Vanessa Bowlin, None; Sandeep S.Samudre, TechniSight Inc. (I); Deepinder K. Dhaliwal, NoneProgram Number: 4357 Poster Board Number: C0095Presentation Time: 8:30 AM - 10:15 AMThe relationship of depression and anxiety with dry eye subtypesLouis Tong 1, 3 , Li-Yue Hong 4 , Ryan Lee 4 , Yang Zhao 4 , Sharon C.Sung 2 , Peggy P. Chiang 4 . 1 Cornea and External Eye Disease Service,Singapore National Eye Ctr, Singapore, Singapore; 2 Office ofClinical Science, Duke-NUS graduate medical school, Singapore,Singapore; 3 Ophthalmology, Yong Loo Lin School of Medicine,National University of Singapore, Singapore, Singapore; 4 SingaporeEye Research Institute, Singapore, Singapore.Purpose: Dry eye syndrome is a common, major health conditionwith association with systemic conditions such as depression andanxiety. We aim to use two previously validated questionnaires toevaluate depression and anxiety in ambulatory eye care setting, anddetermine if specific dry eye subtypes are associated with theseconditions.Methods: This is a prospective cross sectional study performed onEnglish literate patients at the Singapore National Eye Center.Participants were tasked to complete 2 interviewer-assistedquestionnaires: HADS, which screens for anxiety and depression, andCESD, which screens for depression. All participants underwent adry eye symptom questionnaire, tear break up time assessment,corneal fluorescein dye staining, Schirmer’s test, as well as asocioeconomic questionnaire assessment. Patients were classifiedinto evaporative, aqueous deficient or mixed types or symptomaticcategories based on their response to questions and the above testresults.Results: Ninety-six people, mean age 54.5 year (SD: 10.8), of which35.9% men, were recruited. The mean score for CESD was 12.1 (9.8)with 28 subjects (31.5%) having a score of above 16 (previouslypublished threshold). In the HADS the mean score for depressionassociatedquestions was 3.6 (3.6) with 13 subjects (14.1%) having ascore >=8 whereas mean score for the anxiety-associated questionswas 5.3 (3.6) with 24 subjects (26.1%) having a score >=8. AbnormalCESD was significantly associated with symptomatic aqueousdeficient and evaporative dry eyes, mixed dry eyes, and symptomaticmixed dry eyes (odds ratios range from 3.4 - 4.0). The anxiety scoresfrom HADS were significantly associated with symptomaticevaporative and symptomatic mixed dry eyes (odds ratios range (3.04- 3.2), but the HADS depression scores were not associated with anydry eye subtypes.Conclusions: The CESD and HADS were able to detect suspectswith depression and anxiety respectively. Specific types of dry eyepatients, particularly symptomatic ones, showed different tendenciesfor depression and anxiety. The results of these studies haveimplications for the management of chronic dry eye patients as wellas healthcare planning.Commercial Relationships: Louis Tong, None; Li-Yue Hong,None; Ryan Lee, None; Yang Zhao, None; Sharon C. Sung, None;Peggy P. Chiang, NoneSupport: This research is supported by the Singapore NationalResearch Foundation under its clinician scientist awardNMRC/CSA/013/2009 and administered by the Singapore Ministryof Health’s National Medical Research Council. This research issupported by the Singapore Ministry of Health’s National MedicalResearch Council under its individual research grantNMRC/1206/2009 and center grant NMRC/CG/SERI/2010.Program Number: 4358 Poster Board Number: C0096Presentation Time: 8:30 AM - 10:15 AMThe effect of tear lipid biochemistry on tear evaporation rateduring contact lens wearAthira Rohit 1, 2 , Simon H. Brown 3, 1 , Mark D. Willcox 2, 1 , FionaStapleton 1, 2 . 1 Optometry, Brien Holden Vision Institute, Sydney,NSW, Australia; 2 Optometry, School of Optometry and VisionScience, Sydney, NSW, Australia; 3 School of Health Sciences,University of Wollongong, Wollongong, NSW, Australia.Purpose: To understand the association of lipid biochemistry on lipidlayer function during short term contact lens wear.Methods: Fifteen participants with healthy eyes and no prior contactlens wear were recruited. The sample size was calculated based on apilot study of evaporation rates with a standard deviation of 5.6 g/m 2 hto detect a difference between groups at 0.5% significance level with80% power. The study was conducted in two randomized stageswithout and with contact lens wear (Ciba Vision, Focus Dailies, -0.50D).Tear evaporation rate from both eyes was measured using theVapoMeter (Delfin Technologies, Finland) and basal tears werecollected. Tear evaporation rate and tear collection were performed at©2013, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permissionto reproduce any abstract, contact the ARVO Office at arvo@arvo.org.
ARVO 2013 Annual Meeting Abstracts by Scientific Section/Group - Corneathe end of 6 to 8 hours of contact lens wear or similar time with nolens wear. Differences in tear evaporation rate between lens wear andno lens wear were compared using a paired t-test and associationsbetween evaporation rate and concentration of phospholipids in tearfilm lipid layer were assessed using a Pearson correlation coefficient.Results: The mean pre-corneal evaporation rate was 94.3±43.3 g/m 2 hand this was significantly lower (p
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